Background: Upgraded standards for clinical practice guidelines from the Institute of Medicine have not detectably increased the rate of guideline adoption, use and adherence. Evidence-based Guidelines Affecting Policy, Practice and Stakeholders II (E-GAPPS II), a two day conference, will identify and address matters that impact on these issues. As such, it coheres with the AHRQ mission to improve health outcomes by fostering increased understanding and use of evidence from research. Impact: The E-GAPPS conference will be widely disseminated both prior to and after the event, utilizing networks available to its co-sponsors, PC members, and faculty. This will be reinforced through ongoing programmatic activity including via an on-going widely subscribed Webinar series, by posting of the proceedings, including video tapes, slides and other materials, on an open access webpage and through submission of reports to peer reviewed journals. Investigator Team and Environment: E-GAPPS II is sponsored by a partnership between Guidelines International Network North America (G-I-N NA) and the Section on Evidence Based Health Care of the New York Academy of Medicine. This partnership has a proven record of successful collaboration on major conference projects. The investigators have a proven record of experience with funded conference initiatives and involvement with issues centrally related to the content of E-GAPPS II. Innovation/Approach: E-GAPPS II utilizes a previously piloted innovative framework that combines short, interactive plenary presentations with smaller breakout sessions to maximize dialogue. It will use an existing Webinar series to enhance recruitment and dissemination before and after the event. The conference design has been developed by a planning committee (PC) representing a broad range of constituencies using a simplified Delphi approach. Following definition of the governing construct and themes, PC members independently proposed candidate speakers and facilitators for each plenary and breakout session. These were reviewed, consolidated and redistributed until a detailed conference plan was arrived at by consensus. It addresses 4 themes, all encompassed within the global theme of implementation and use of guidelines: 1. early stakeholder engagement; 2. collaboration and minimization of conflict across guideline efforts; 3. adaptation and implementation; and, 4. decision support, encompassing patient-centered modalities such as shared decision making. The conference design is patient centered and emphasizes issues of immediate interest to AHRQ priority populations. E.g., Theme 2 will focus on the challenges to guideline implementation posed by frail elderly patients with multiple health conditions. E- GAPPS will be evaluated using post-conference and follow-up surveys of faculty and audience participants, and by means of post conference interactive Webinar sessions.